Individual
JUSTIN JOHN KACZMAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3722
Mailing address
4081 W 158TH ST, CLEVELAND, OH 44135-1233
(440) 773-0597
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0034216
OH
Other
Enumeration date
06/29/2023
Last updated
06/29/2023
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